APPLICATION FOR PROVISIONAL REALTOR® & DESIGNATED …



Berkshire County Board Of Realtors®, Inc.

Reinstatement for Realtor® Membership

REALTOR® Membership can be reinstated within one (1) calendar year. A reinstatement fee applies and dues for the current calendar year must be paid in full, and are not prorated.

Full Name as it appears on license:      

Salutation: Ms. Mrs. Mr. Dr. Nickname:      

Agent Contact Information

Name for Roster:      

Home Address:      

Apt / Care of:      

City:       State:      Zip:      

Home Phone: (     )      -     

Personal Fax: (     )      -     

Mobile or Cell:: (     )      -     

E-Mail:      

Personal Website:      

Office Contact Information

Office:      

Designated REALTOR:      

Preferred Mailing Address: Home - or - Office Add’l Phone #’s to appear on roster Home Mobile

Preferred Phone #’s Home Mobile - or - Office

Real Estate License History

1. License #       Exp Date       Type: Broker Sales Appraisal

2. Do you hold, or have you ever held, a real estate license in any other state? If yes, please specify:      

3. Has your real estate license, in this or any other state, been suspended or revoked? Yes No

4. If “yes”, specify the place(s) and date(s) of such action, and detail the circumstances relating thereto:      

Realtor® Membership Information: Membership ID (NRDS#), if known      

5. Birth Date:      /     /     

6. Member Type: Realtor® Designated Realtor® (Broker/ Principal responsible for all office obligations)

7. Office Status: Principal/Partner Office Manager Employee Independent Contractor

8. Realtor® Membership Type Primary Member Secondary* (must hold current membership elsewhere)

9. Do you currently hold Realtor® membership in any other Association? No Yes

If yes, please specify      

Realtor® Membership Information Continued…

10. Have there been any complaints/cases against you before any real estate association, state real estate regulatory agency or any other agency of government within the last three years? No Yes – If yes, specify the substance of each complaint in each state, the agency before which complaint was made, and the current status or resolution of such complaint:      

11. Have you ever been convicted of a felony? No Yes - If yes, please give details including state and court of conviction:      

Professional Information:

Note: This information is not used to assess your membership qualifications. It is simply to allow the Board of Realtors® to tailor our services and promotional efforts for your specialties. You can change or update this information at any time by contacting the Board office. You do not need to complete this section for membership consideration.

12. Professional Designation or Degrees held:      

13. Year first entered Real Estate Business:       City / State:      

14. Have you been engaged continuously in the business since then? Yes, at least part-time since licensed No, stopped or never actively practiced real estate – or - Occasionally engaged in real estate when circumstances permitted.

15. Other Profession/ Business Experience:      

16. Are you now engaged in any other business? No, not at this time Yes: (Position)      

17. Resident here since       Previous residence:      

18. Do you hold any governmental positions No, not at this time Yes: (Position)      

19. Do you currently belong to any organizations? (ie: business, civic, charitable or other)      

20. Do you hold any leadership roles in other organizations? No, not at this time Yes: (Position)      

21. Would you like more information on the benefits of serving in volunteer leadership? If yes, your interests:

Education Housing Opportunities Government Affairs Professional Standards Community Service

22. Business Area: Check all that apply:

North Berkshire Central Berkshire South Berkshire

New York / Connecticut / Vermont Pioneer Valley Other:     

23. Professional Specialties: Check all that apply

Residential Sales Residential Rental Condominiums

Land / lots Commercial Other:     

24. Brokerage Type Offered:

Buyer and Seller Representation Exclusive Buyer Representation Exclusive Seller Representation

Transactional Brokerage Limited Service Other:     

25. Are there any other interests, accomplishments or skills you possess that you would like to share with us?      

I hereby apply for Realtor® membership in Berkshire County Board of Realtors, and enclose payment in the amount of…

$ 50.00 Reinstatement Fee and $_      ___ dues = $__      __ total paid

…which I understand will be returned to me in the event I am not accepted to membership. In the event my application is approved, I agree as a condition to membership to complete one of the next two Orientation programs offered by the Berkshire County Board of Realtors®. I agree to, upon my own initiative, thoroughly familiarize myself with the Code of Ethics of the National Association of Realtors® and with the governing documents of the Board of Realtors®, which is continually available on the Board’s website . I further agree to complete satisfactorily a reasonable and nondiscriminatory written examination covering such Code, Constitutions, Bylaws, Rules and Regulations and duty to arbitrate.

I agree that my act of paying dues shall evidence my initial and continuing commitment to abide by the aforementioned Code of Ethics, Constitutions, Bylaws, Rules and Regulations, and duty to arbitrate, all as from time to time amended. I consent and authorize the Board, through its Membership Committee or otherwise, to invite and receive information and comment about me from any Member or other person, and I agree that any information and comment furnished to the Board by any Member or other person in response to any such invitation shall be conclusively deemed to be privileged and not form the basis of any action by me for slander, libel, or defamation of character.

NOTE: Applicant acknowledges that if accepted as a Member and he/she subsequently resigns or is expelled from membership in the Board with an ethics complaint or arbitration request pending, the Board of Directors may condition renewal of membership upon applicant’s verification that he/she will submit to the pending ethics or arbitration proceeding and will abide by the decision of the Hearing Panel; or if applicant resigns or is expelled from membership without having complied with an award in arbitration, the Board of Directors may condition renewal of membership upon his/her payment of the award, plus any costs that have been established previously as due and payable in relation thereto, provided that the award and such costs have not, in the interim, been otherwise satisfied.

NOTE: Dues payments are not tax deductible as charitable contributions. Portions of such payments may be tax deductible as ordinary and necessary business expenses.

Applicant acknowledges that this application must be administratively approved before Provisional Membership is activated. Applicant further understands that they will receive two opportunities to attend a mandatory, full-day orientation program. Provisional membership will either be amended to “Full REALTOR®” status upon completion of the program or be terminated for non-attendance. In the event provisional membership is terminated, no refunds will be provided. Additionally, submission of a new application and application fee will be required to reapply for provisional membership and current year dues, if not already remitted, will be due and payable.

Further, I agree that, if accepted for Membership in the Board, I shall pay the fees and dues as from time to time established.

I hereby certify that the foregoing information furnished by me is true and correct, and I agree that failure to provide complete and accurate information as requested, or any misstatement of fact, may be grounds for revocation of my membership if granted.

Signature: ____________________________________ Date: ____/____/____

The Board Office will verify that your membership in the Berkshire County Board of REALTORS® was terminated not less than one year ago and will establish Massachusetts real estate licensing information. After that time, you will be assigned a new sign-on and password for the MLS system and your REALTOR® services will be activated.

Credit Card Authorization Form, if desired

The Berkshire County Board of REALTORS® can hereby charge the following credit card for:

An Application Fee, in the amount of $50.00

Full Membership Dues in the amount of      _______

For a Total of:      _______

Credit Card: Discover American Express Master Card Visa

Credit Card #                 /                 /                 /                

Expiration Date:         /        

Name as it appears on Card:      

Billing Address:      

Signature of Card Holder:

2015 Berkshire Realtor® Dues

|Dues 2014: |Jan-Dec Full Year Dues |

| Local: (Berkshire) |$219.00 |

| State (Mass.)* |$151.00 |

| National (NAR)* |$155.00 |

| Total 2014 Dues: |$525.00 |

* Note: Secondary REALTOR® members need only pay local dues and application fee, with proof (letter in good standing) of membership with another local association in Massachusetts or with a local and state association contiguous to Mass.

-----------------------

Member Information

I, the undersigned Designated REALTOR® (DR) of the above named company, confirm that the licensed real estate agent listed here is affiliated with my real estate firm and I accept oversight responsibility for their actions in connection with all governing documents of the Berkshire County Board of Realtors and Multiple Listing Service. [DR to Signature Required]

⎦

Membership Agreement – All Applicants must complete

Please Attach a Copy of Current Real Estate or Appraisal License Here

*REQUIRED FOR ACCEPTANCE OF APPLICATION*

PROCESS FOR REINSTATING REALTOR® MEMBERSHIP

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download